Patient Forms

POLICY FORMS

FINANCIAL POLICY

Financial Policy

NOTICE OF PRIVACY PRACTICES

Notice of Privacy Practices

RECORD RELEASE FORM

Record Release Form

OPIOID INFORMED CONSENT

Opioid Informed Consent

New Patient Forms

GENERAL APPOINTMENT FORM

Website form General Appointment


HIP APPOINTMENT FORM

Website form General Appointment

FRACTURE OR INJURY FORM

Website form Fracture or Injury

KNEE APPOINTMENT FORM

Website form Knee Appointment

SHOULDER APPOINTMENT FORM

Website form Shoulder Appointment

COVID - 19An update from our office
Dear Traverse City Orthopedic patients,

Due to the COVID-19 global pandemic, we are taking necessary precautions to do our part to prevent the spread of this illness by limiting our patient appointments over the next several weeks. If you currently have an appointment scheduled that is not of urgent nature, you will be contacted by our office staff.

We are mandated to perform pre-screening of any patient that presents to our office & you may be asked to reschedule based on the results.

To limit the number of people in our office at one time, we ask that anyone coming with you to your appointment remain in the vehicle unless you need assistance getting inside. We may also request that you complete your paperwork in your vehicle to keep with social distancing standards.

Furthermore, we are unable to board elective surgical cases until further notice is given to us by our local hospital & outpatient facilities.

We will be diligent in doing our part to abide by CDC guidelines and just want to remind everyone that hand washing, personal hygiene & social distancing are the best defense right now as we continue to learn more.

We will be limiting staff but will have systems in place to have your questions answered regarding your care.

Thank you for your understanding.